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Olufunmi Wallace

NPI 1265321426 · on the registry since 2025

Practice

Address: 12029 Avalon Blvd
Los Angeles, CA 90061
Phone: (323) 756-8191
Organisation at this address: Avalon Post Acute Llc
Avalon Villa Health Care Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: Licensed Vocational Nurse
164X00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2025-07-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California